Tackle-injury epidemiology in koshuis rugby players at Stellenbosch University

Background. The tackle is an important component of rugby union. The tackle situation carries the  highest risk for injury for both the ball carrier and tackler. Little is known about the epidemiology of tackle injuries in koshuis rugby players.Objectives. To (i) calculate the tackle-related injury rate, (ii) determine if the tackler or ball carrier is more susceptible to injury, and (iii) determine the most common location and type of injury during tackles.Methods. Data were collected by means of injury report forms from the medical centre during koshuis matches of 2012 and 2013. All data collected were captured into an online database. Only data related to tackle injuries were evaluated for this retrospective, descriptive epidemiological study.Results. The tackle led to 61% of all injuries (11.4 injuries/1 000 playing hours). The tackler sustained 23% more injuries than the ball carrier. Injuries to the face (3.1 injuries/1 000 playing hours, 95%  confidence interval (CI) 2.8 - 3.3) were most prevalent. The most common type of injury was lacerations (3.4 injuries/1 000 playing hours, 95% CI 3.2 - 3.7).Conclusion. The tackle contributed to 61% of all injuries, making it the most dangerous phase of play. The tackler is more at risk than the ball carrier, especially for injuries to the face, with lacerations having the highest prevalence. For the ball carrier the location of the most injuries was the head, although joint sprains were the most common type of injury for the ball carrier

Inadvertent doping through nutritional supplements is a reality

Objective. Inadvertent doping through the use of nutritional supplements is a potentially important cause of the increase in positive drug tests involving high-profile Olympic athletes. The aim of this study was to screen over-the-counter nutritional supplements for the presence of steroid or stimulant compounds banned by the International Olympic Committee (IOC) and the World Anti-Doping Agency (WADA). Method. Thirty different nutritional supplements from 14 different manufacturers were bought at shops in Bloemfontein, South Africa and analysed for testosterone and nandrolone prohormones, various ephedrines and caffeine. Results. Eighteen (60%) of the 30 supplements contained no prohibited substances. Of the 12 (40%) positive supplements, 8 (66.7%) contained prohormones and 4 (33.3%) contained stimulants. Six supplements contained prohormones, which were listed on the labels, while 2 contained prohormones not listed on the labels. The stimulants were listed on the labels as Ma Huang, Guarana and Kola extracts and all contained a mixture of ephedrines and caffeine. Conclusion. The results showed that approximately 7% of supplements tested may be mislabelled or contaminated with banned substances and that inadvertent doping through nutritional supplement use is a reality for athletes. The sporting community should therefore be aware that supplements might contain anabolic androgenic steroids and stimulants that are not declared on the labels. SA Sports Medicine Vol.16(2) 2004: 3-

Application opportunities of geographic information systems analysis to support achievement of the UNAIDS 90-90-90 targets in South Africa

In an effort to achieve control of the HIV epidemic, 90-90-90 targets have been proposed whereby 90% of the HIV-infected population should know their status, 90% of those diagnosed should be receiving antiretroviral therapy, and 90% of those on treatment should be virologically suppressed. In this article we present approaches for using relatively simple geographic information systems (GIS) analyses of routinely available data to support HIV programme management towards achieving the 90-90-90 targets, with a focus on South Africa (SA) and other high-prevalence settings in low- and middle-income countries. We present programme-level GIS applications to map aggregated health data and individual-level applications to track distinct patients. We illustrate these applications using data from City of Johannesburg Region D, demonstrating that GIS has great potential to guide HIV programme operations and assist in achieving the 90-90-90 targets in SA

Wellness testing on recruits to determine current state of wellbeing

Through the evaluation of the wellbeing of recruits, a preventative life style approach can be re-enforced, lowering the risk of various diseases and conditions. This study was conducted in order to determine the current wellbeing of recruits at various locations in the country. All institutes revealed a high risk concerning body mass index and coordination. Institute 1 and Institute 2 attained elevated heart health readings. The waist-to-hip ratios in Institute 2 and Institute 3 proved to be high risk areas. Furthermore, Institute 3 indicated a high stress index and a high risk overall fitness in comparison to the other training institutes.This paper was initially delivered at the Annual Congress of the Biological Sciences Division of the South African Academy for Science and Art, ARC-Plant Protection Research Institute, Roodeplaat, Pretoria, South Africa on 01 October 2010.http://www.satnt.ac.zaam2014ay201

Delivering HIV services in partnership: factors affecting collaborative working in a South African HIV programme

Abstract Background The involvement of Global Health Initiatives (GHIs) in delivering health services in low and middle income countries (LMICs) depends on effective collaborative working at scales from the local to the international, and a single GHI is effectively constructed of multiple collaborations. Research is needed focusing on how collaboration functions in GHIs at the level of health service management. Here, collaboration between local implementing agencies and departments of health involves distinct power dynamics and tensions. Using qualitative data from an evaluation of a health partnership in South Africa, this article examines how organisational power dynamics affected the operation of the partnership across five dimensions of collaboration: governance, administration, organisational autonomy, mutuality, and norms of trust and reciprocity. Results Managing the tension between the power to provide resources held by the implementing agency and the local Departments’ of Health power to access the populations in need of these resources proved critical to ensuring that the collaboration achieved its aims and shaped the way that each domain of collaboration functioned in the partnership. Conclusions These findings suggest that it is important for public health practitioners to critically examine the ways in which collaboration functions across the scales in which they work and to pay particular attention to how local power dynamics between partner organisations affect programme implementation

Haematopoietic stem cell transplantation in South Africa: Current limitations and future perspectives

The growing need for haematopoietic stem cell transplantation (HSCT) is reflected in the increasing number of transplants performed globally each year. HSCT provides life-changing and potentially curative therapy for a range of pathologies including haematological malignancies; other indications include certain congenital and acquired disorders of the haematopoietic system, autoimmune conditions and hereditary diseases. The primary goals of HSCT are either to replace haematopoietic stem and progenitor cells (HSPC) following myeloablative chemotherapy or to cure the original pathology with allogeneic HSPCs. Success depends on optimal outcomes at various stages of the procedure including mobilisation of marrow stem/progenitor cells for harvesting from the patient or donor, long-term and sustainable engraftment of these cells in the recipient, and prevention of graft-versus-host disease in the case of allogeneic HSCT. Challenges in South Africa include high cost, limited infrastructure and lack of appropriately trained staff, as well as limitations in securing suitable haematopoietic stem cell donors. This review aims to provide an overview of HSCT and some of the challenges that are faced in the South African context

Implementation of an electronic monitoring and evaluation system for the antiretroviral treatment programme in the Cape Winelands district, South Africa: a qualitative evaluation

BACKGROUND: A pragmatic three-tiered approach to monitor the world's largest antiretroviral treatment (ART) programme was adopted by the South African National Department of Health in 2010. With the rapid expansion of the programme, the limitations of the paper-based register (tier 1) were the catalyst for implementation of the stand-alone electronic register (tier 2), which offers simple digitisation of the paper-based register. This article engages with theory on implementation to identify and contextualise enabling and constraining factors for implementation of the electronic register, to describe experiences and use of the register, and to make recommendations for implementation in similar settings where standardisation of ART monitoring and evaluation has not been achieved. METHODS: We conducted a qualitative evaluation of the roll-out of the register. This comprised twenty in-depth interviews with a diverse sample of stakeholders at facility, sub-district, and district levels of the health system. Facility-level participants were selected across five sub-districts, including one facility per sub-district. Responses were coded and analysed using a thematic approach. An implementation science framework guided interpretation of the data. Results & DISCUSSION: We identified the following seven themes: 1) ease of implementation, 2) perceived value of an electronic M&E system, 3) importance of stakeholder engagement, 4) influence of a data champion, 5) operational and logistical factors, 6) workload and role clarity, and 7) importance of integrating the electronic register with routine facility monitoring and evaluation. Interpreting our findings through an implementation theory enabled us to construct the scaffolding for implementation across the five facility-settings. This approach illustrated that implementation was not a linear process but occurred at two nodes: at the adoption of the register for roll-out, and at implementation at facility-level. CONCLUSION: In this study we found that relative advantage of an intervention and stakeholder engagement are critical to implementation. We suggest that without these aspects of implementation, formative and summative outcomes of implementation at both the adoption and coalface stages of implementation would be negatively affected

PAPER-64 Constraints On Reionization II: The Temperature Of The z=8.4 Intergalactic Medium

We present constraints on both the kinetic temperature of the intergalactic medium (IGM) at z=8.4, and on models for heating the IGM at high-redshift with X-ray emission from the first collapsed objects. These constraints are derived using a semi-analytic method to explore the new measurements of the 21 cm power spectrum from the Donald C. Backer Precision Array for Probing the Epoch of Reionization (PAPER), which were presented in a companion paper, Ali et al. (2015). Twenty-one cm power spectra with amplitudes of hundreds of mK^2 can be generically produced if the kinetic temperature of the IGM is significantly below the temperature of the Cosmic Microwave Background (CMB); as such, the new results from PAPER place lower limits on the IGM temperature at z=8.4. Allowing for the unknown ionization state of the IGM, our measurements find the IGM temperature to be above ~5 K for neutral fractions between 10% and 85%, above ~7 K for neutral fractions between 15% and 80%, or above ~10 K for neutral fractions between 30% and 70%. We also calculate the heating of the IGM that would be provided by the observed high redshift galaxy population, and find that for most models, these galaxies are sufficient to bring the IGM temperature above our lower limits. However, there are significant ranges of parameter space that could produce a signal ruled out by the PAPER measurements; models with a steep drop-off in the star formation rate density at high redshifts or with relatively low values for the X-ray to star formation rate efficiency of high redshift galaxies are generally disfavored. The PAPER measurements are consistent with (but do not constrain) a hydrogen spin temperature above the CMB temperature, a situation which we find to be generally predicted if galaxies fainter than the current detection limits of optical/NIR surveys are included in calculations of X-ray heating.Comment: companion paper to Ali et al. (2015), ApJ 809, 61; matches version accepted to ApJ; 11 pages, 7 figure